The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology
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Randomized Controlled Trial Clinical Trial
Influence of moderate alcohol consumption on obstructive sleep apnoea with and without AutoSet nasal CPAP therapy.
Snoring worsens with high alcohol consumption. It is unclear whether moderate alcohol intake worsens sleep and breathing in subjects with obstructive sleep apnoea syndrome (OSAS), and whether alcohol increases the pressure requirement for nasal continuous positive airway pressure (CPAP). Fourteen adult males with untreated OSAS but without heart or lung disease were studied (age 53+/-9 yrs, body mass index (BMI) 33+/-5 kg x m(-2) (mean+/-SD). ⋯ There was no change in the pressure requirement for CPAP (full night: control 11.9+/-0.9 vs alcohol 12.5+/-0.9 cm H2O; first 2 h: 10.9+/-0.6 vs 11.1+/-0.8 cm H2O). Moderate alcohol intake (in the form of vodka) has little effect on breathing or saturation during sleep in subjects with mild-to-severe obstructive sleep apnoea, and no effect on the pressure required for continuous positive airway pressure in order to prevent apnoea, snoring, and flow limitation. These results cannot be extrapolated to other doses or forms of alcohol, or to subjects with concurrent heart or lung disease.
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Four brands of ventilator used for noninvasive positive pressure ventilation in the home were assessed to determine their performance on a patient simulator. We tested the tidal volume (VT) preset Companion 2801 (Puritan Bennett), minute volume preset Monnal D (Taema), and two pressure preset ventilators, the Nippy (Friday Medical) and the Bilevel Positive Airway Pressure (BiPAP) (Respironics). A patient simulator was employed to investigate the relationships between VT, peak airway pressure (PAP) and mean airway pressure (MAP), the responses to an additional leak in the circuit and patient effort of a variable duration, which was modelled using a negative pressure pump. ⋯ When patient effort was prolonged to 1.5 s, a similar length to the inspiratory time of the ventilators, there was no further change in the minute volume of the Companion 2801 and Monnal D, while that of the Nippy and of the BiPAP increased by 38 and 71%, respectively, compared to baseline. These results show that distinct brands of ventilator respond to changes in the patient and patient circuit in different ways, which are not always predictable from a simple description of their operating principles. This should be borne in mind when choosing a positive pressure ventilator for noninvasive ventilation.